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¿Quién todavía no tiene seguro en Minnesota? Lecciones de los esfuerzos de reforma del Estado
1Institute for Health Services Research, School of Public Health, University of Minnesota, Minneapolis 55455, USA. callx001@gold.tc.umn.edu
JAMA
|October 27, 1997
Resumen
MinnesotaCare mantuvo baja la falta de seguro y mejoró el acceso de los niños al seguro de salud. El plan subvencionado por el estado fue efectivo para los niños, pero menos para los adultos solteros.
Área de la Ciencia:
- Servicios de salud Servicios de salud Investigación Investigación.
- Política de salud pública Política de salud pública.
- Economía de la salud Economía de la salud
Sus antecedentes:
- Las iniciativas estatales de reforma de la salud son cruciales para hacer frente a la falta de seguro.
- Comprender el impacto de programas como MinnesotaCare es vital para la política nacional.
- El seguimiento de las tasas de falta de seguro, especialmente para las poblaciones vulnerables, informa las estrategias de salud pública.
Objetivo del estudio:
- Evaluar los esfuerzos de reforma de la atención médica de Minnesota, centrándose en las tasas de no seguro y la efectividad de MinnesotaCare.
- Analizar los cambios en el acceso de los niños al seguro de salud entre 1990 y 1995.
- Evaluar el éxito de MinnesotaCare en servir a su población objetivo y sus implicaciones para una reforma más amplia.
Principales métodos:
- Utilizó tres encuestas telefónicas transversales realizadas en 1990, 1995 y 1994.
- Empleó muestreo aleatorio en dos etapas para encuestas estatales y muestreo aleatorio estratificado para los inscritos de MinnesotaCare.
- Analizó los cambios en las tasas de no seguro utilizando datos de más de 10,000 encuestados por encuesta estatal.
Principales resultados:
- La tasa de personas sin seguro de Minnesota se mantuvo estable en el 6% entre 1990 y 1995, en contraste con los aumentos nacionales.
- La proporción de niños sin seguro por más de 12 meses disminuyó significativamente (del 5,2% al 3,1%).
- Las tasas de personas sin seguro para adultos solteros se mantuvieron estables en torno al 11%; no se encontró evidencia de juego de programas o erosión del mercado privado.
Conclusiones:
- MinnesotaCare mantuvo con éxito bajas tasas de no seguro y mejoró la cobertura de seguros para niños.
- El programa mostró menos efectividad en la inscripción de adultos solteros, aunque las expansiones recientes pueden alterar esto.
- La experiencia de Minnesota proporciona un modelo para las reformas estatales y nacionales dirigidas a reducir la falta de seguro, especialmente para los niños.
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